P1626: MANAGEMENT OF POST-TRANSFUSION COMPLICATIONS IN PATIENTS WITH HEMATOLOGICAL DISEASES. PREVENTION IS BETTER THAN CURE–DATA FROM A SINGLE INSTITUTION
Authors: Y. Lazarova, G. Balatzenko, E. Aleksov, M. Stoyanova, K. Venkov, K. Milcheva, G. Arnaudov, M. Donchev, K. Ignatova, B. Spassov
Journal: HemaSphere (2022)

Background: Post-transfusion complications (PTC) include acute (AHTR) and delayed (DHTR) hemolytic reaction, chill-rigor reaction, febrile non-hemolytic reaction (FNHR), Transfusion-related acute lung injury (TRALI), transfusion-associated circulatory overload (TACO), allergic (ATRs), anaphylactic reactions– are the risk of transfusion support. According to American Society of Hematology the frequency of adverse effects of transfusion is approximately: AHTR–1:76,000, FNHR–0,1–1%, ATRs–1–3%, anaphylactic reactions–1:20, 000–50, 000, TRALI–1:10, 000, TACO-1%. The safety and effectiveness of transfusion medicine, foremost in treatment in oncohematology, undoubtedly depends equally on the quality of transfusion therapy and the chosen specificity in transfusion approach in different hematological diseases. Aims: Analyzing the frequency of PTC in pts with hematological diseases–chill-rigor reaction, AHTR, DHTR, FNHR, TACO, TRALI, ATRs, anaphylactic shock, bacterial sepsis. Methods: Routine manual technique and column-agglutination technique for blood typing, screening and identification of anti-erythrocyte antibodies (agglutination, enzyme method, direct and indirect antiglobulin test), in vitro compatibility tests on all methods and techniques as necessary. Materials: The number of all transfused pts and units of blood components in the Specialized Hospital for Active Therapy of Hematological Diseases for the 2020– 2021 period were: pts–2,521 adults (665 transfused only with red cell concentrates–RCCs,98 of whom with Beta Thalassemia); all blood components(units)–20,040, of which –9,743 RCCs, 3,084 platelet concentrates by apheresis (PCAP), 5,090 PC from whole blood(PCWB), 2,099 fresh frozen plasma(FFP), (severe clinical cases with post-transfusion complications–delayed hemolytic transfusion reactions, anaphylactic reactions–will be outlined), alloimmunization from RCCs–26 pts. Results: Complications of transfusion were found in 80cases in total (0.4% of all transfused blood units; 3.2% of all transfused pts). The frequency of complications within the 80 total cases was as follows–AHTR–0, DHTR–1(1.25%), chill-rigor reactions–19(23.75%), FNHR–13(16.25%), ATRs–20(25%), anaphylactic shock–2(2.5%), TRALI–0, TACO–0, septic reaction–0. The frequency of post-transfusion reactions of transfused blood components was respectively: chill-rigor reactions in RCCs–9(0.09%), in FFP–3(0.14%), in PC–7(0.09%); FNHR in RCCs–10(0.1%), in PC–2(0.02%); ATRs in PC–19(0.23%), in FFP–1(0.05%); anaphylactic reactions in PCAP–2(0.06%). In 59 AIHA treated in our center, 29(49.2%) transfused with RCCs and 14(23.7%) alloimmunizated–the frequency of specificity was: anti-E (42.9%), anti–E+ c (14.3%), anti–Kell (21.4%), anti–Cw, Jk a, Lea (7.1% vs 7.1% vs 7.1% respectively). Post-transfusion hemolytic reactions were not observed. Image:Summary/Conclusion: In this analysis from our center the frequency of PTC was the same as the world frequency reported. Fatal post-transfusion reaction or acute hemolytic reaction was not observed. A longer period of research is needed to determine the frequency of TACO and TRALI.